Hepatitis B

In some cases of hepatitis B virus (HBV) infection, the virus will not be eliminated and the person will become chronically infected. People with chronic HBV may transmit infection vertically (from mother to baby), or through sexual or percutaneous exposure.

Even if they appear to be healthy, people with chronic HBV should be monitored regularly (every 6-12 months) by their GP for signs and symptoms of liver disease. Treatment of chronic hepatitis B (external site) significantly reduces progressive liver damage and loss of liver function. GP's authorised by WA Health can now prescribe hepatitis B medicines.

HBV is mainly spread through direct contact with infected blood and blood products, but can also be sexually transmitted. Those at high-risk of HBV include:

  • people who inject drugs
  • men who have sex with men
  • people with multiple sexual partners, including sex workers
  • partners and household contacts of people with acute or chronic hepatitis B.

The National Health and Medical Research Council's (NHMRC) Immunisation Handbook (external site) recommends that the following groups are among those who should receive hepatitis B vaccine:

  • household or other close (household like) contacts of people with hepatitis B
  • sexual contacts of people with hepatitis B
  • men who have sex with men
  • people who inject drugs
  • sex industry workers
  • individuals with chronic liver disease and/or hepatitis C
  • haemodialysis patients, HIV positive people and other adults with impaired immunity
  • inmates and staff of long-term correctional facilities
  • healthcare workers, ambulance personnel, dentists, embalmers, tattooists and body-piercers
  • Aboriginal and Torres Strait Islanders people.

Standard regimes for vaccination include:

  • 0, 1 and 6 months
  • 0, 1, 2 and 12 months
  • 0, 7, 21 days and 12 months for rapid vaccination of those at highest risk.

Vaccination should be administered into the deltoid muscle.

If doses are missed the course does not need to be restarted, but all doses should be completed. Seroconversion should be documented in these high-risk groups to ensure immunity. If seroconversion does not occur, further doses of vaccine can be given at two-month intervals, up to a maximum of three more.

Post-exposure prophylaxis

Percutaneous contacts should be given hepatitis B immunoglobulin (HBIG) 400 IU intramuscularly, as a single dose within 72 hours of exposure.

Individuals sexually exposed should be given HBIG within two weeks of sexual contact. Adults should be given HBIG 400 IU intramuscularly, as a single dose, and vaccination commenced. Hepatitis B vaccination and immunoglobulin can be given at the same time, but at different sites.

Public health issues

  • Notify WA Health of any cases of HBV.
  • Sexual, injecting drug use and house-hold contacts should be given specific HBIG prophylaxis followed by vaccination.
  • Percutaneous contacts should have HBIG within 72 hours.
  • Other contacts should receive HBIG within two weeks.
  • Contact tracing is important to prevent further transmission of HBV.
  • Vaccinate for hepatitis A if chronically infected with HBV.

Related links